Year: 2015
Type: dissertation
Study design: Observational Study
Abstract: Intubation in a Physician-led Trauma Service'.3. Published in Resuscitation, October 2013 under the title 'An observational study of paediatric pre-hospital intubation and anaesthesia in 1933 children attended by a physician-led, pre-hospital trauma service,.1 (Appendix 1) Abstract IntroductionTrauma accounts for 16-44% of childhood deaths.The number of severely injured children who require pre-hospital advanced airway management is thought to be small, but there is little published data detailing the epidemiology of these interventions.This study was designed to evaluate the children who received prehospital intubation (with or without anaesthesia) in a high volume, doctor-led, prehospital trauma service and the circumstances surrounding the intervention. MethodsA 12 year retrospective database analysis was conducted.All paediatric patients «16 years of age) that were attended and received pre-hospital advanced airway management were included.The total number of pre-hospital intubations and the proportion that received a rapid sequence intubation (RSI) were established.To illustrate the context of these interventions the demographics, injury mechanisms, intervention success rates and scene times were recorded. Results Between 1 January 2000 and 31 October 2011 the service attended 1933 children.There were 315 (16.3%) pre-hospital paediatric intubations.Of those intubated, 81 % received an RSI and 19% were intubated without anaesthesia in the setting of near v or actual cardiac arrest.Nearly three quarters of the patients were in the age range of 6 -15 years with only 3 patients under the age of 1 year.The most common injury mechanisms that required intubation were road traffic crashes (RTCs) and 'falls from height'.These accounted for 79% of patients receiving intubation.Intubation success rate was 99.7% with a single failed intubation during the study period.Mean onscene time was 41 minutes when RSI was delivered. ConclusionPre-hospital paediatric intubation is not infrequent in this high-volume trauma service.The majority of patients received an RSI.The commonest injuries associated with intubation were blunt trauma caused by RTCs and 'falls from height'.Pre-hospital paediatric intubation is associated with a high success rate in this service.vi
Author: Daniel Nevin
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2226712091